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NUR 4455 ( LATEST 2024 / 2025 ) EXAM 2 | NEW FULL QUESTIONS AND ANSWERS 100% CORRECT
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NUR 4455 ( LATEST 2024 / 2025 ) EXAM 2 | NEW FULL QUESTIONS AND ANSWERS 100% CORRECT
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NUR 4455 Exam 21. Stage 1 of Labor
Answer
BEGINS w/ regular contractions until 10 cm dilation and 100 percent effacement
2. Which test would provide evidence of fetal blood flow in maternal circulation?
Answer
Positive Kleihauer-betke test
3. Which postpartum perineal care techniques demonstrate client understanding of proper care?
(3)
Answer
- Using soap and warm water to wash the vulva and perineum
- Washing from the symphysis pubis back to the episiotomy
- Changing her perineal pad every 2 to 3 hours
4. Which vaccines are appropriate to include when informing a postpartum client? Select all
that apply
Rubella vaccine
Varicella vaccine
Smallpox vaccine
Yellow fever vaccine
Tetanus-diphtheria-acellular pertussis (Tdap) vaccine
Answer
Rubella vaccine Varicella vaccineT
,Tetanus-diphtheria-acellular pertussis (Tdap) vaccine
Routine vaccines that are prescribed in the postpartum period. The rubella vaccine provides
immunity against the rubella virus during future pregnancies. The HCP may prescribe a
varicella vaccine before discharging the postpartum client if she has no immunity against the
varicella zoster virus. The tetanus-diphtheria-acellular pertussis (Tdap) vaccine helps protect the
client from pertussis and decreases the risk of the infant's exposure to pertussis. The smallpox
vaccine and the yellow fever vaccine are not given in the postpartum period.p. 433
5. Positive Homan's sign
Answer
Pain in the calf upon flexing the knee and arching or cramping upon dorsiflexion of the foot.
6. Which nursing information is appropriate for the client who had a vaginal delivery and asks
the nurse about the timing of her discharge home?
Answer
"You are allowed to remain in the hospital for at least 48 hours after delivery."
RationaleAccording to the Newborns' and Mothers' Health Protection Act of 1996, all health plans
allow the newborn and mother to remain in the hospital for a minimum of 48 hours after vaginal
delivery. If there are any complications, the client may need to stay in the hospital for a longer
period and would not be discharged after 48 hours.The client cannot opt for discharge without
consulting the primary health care provider. The client would not be discharged in 24 hours
because she should be observed for 48hours for postpartum complications.
7. Which four components are included in a cultural assessment?
Answer
Infant care and attachment
,Primary language spoken
Ability to read and write English
Religious or cultural beliefs and folk medicine practices
8. What are afterpains? When do they resolve? When are they more notice- able? What
intensifies this feeling? How are they different in multiparous vs primiparous women?
Answer
- cramping sensations resulting from the contraction of the uterus after birth
- 3 to 7 days
- after births w/ overdistended uterus (e.g., large infant, multifetal gestation, polyhydramnios)
- oxytocin (stimulation of uterine contractions)
- primi- mild cramping VS. multi- more severe and more common
9. What three two decrease after birth? When do they reach their lowest? Why?
Answer
- estrogen and progesterone; reach their lowest levels 1 week after birth
- decreased estrogen levels = diuresis of excess ECF fluid accumulated during pregnancy
- nonlactating women, estrogen levels begin to increase
10. When does estrogen reach its highest in nonlactating women?
Answer
day 17
11. How long can HCG be detected in women until they are gone?
Answer
can be detected in the maternal system 3-4w after birth
, 12. What is prolactin produced by?
Answer
anterior pituitary
13. What two hormones begin to rise (one for as progesterone falls)? What is this hormone
responsible for?
Answer
- prolactin as progesterone falls and oxytocin
- oxytocin = nipple stimulation with milk expression; triggers milk ejection
- progesterone = milk production
14. Describe the levels of prolactin throughout the postpartum period.
Answer
- high- est the first month after birth
15. What are prolactin levels influenced by (3)?
Answer
feeding frequency, duration and level of supplementation
16. When do prolactin levels reach the pre-pregnant range postpartum?
Answer
- the third postpartum week
17.
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